Organization
MARYLAND WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL ROSENBLATT LCPC (FOUNDER, THERAPIST)
(301) 788-8326
Entity
Organization
Contact information
Practice address
11140 ROCKVILLE PIKE STE 421, ROCKVILLE, MD 20852-3104
(301) 678-3281
Mailing address
11870 GRAND PARK AVE APT 924, ROCKVILLE, MD 20852-8702
(301) 788-8326
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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